# EXCESS THIRD PARTY LIABILITY POLICY

**Affiliated FM Insurance Company**
**Appalachian Insurance Company**

P. O. Box 7500, Johnston, Rhode Island 02919

## DECLARATIONS

**Policy No. XL 96794**

- **Item 1. Name of Insured:** International Business Machines (and per Endorsement No. 1)
- **P.O. Address:** Armonk, New York 10504
- **Item 2. Location of Coverage:** as above and as further defined in the Primary Policy.
- **Item 3. Policy Period:** From 5/21/77 To 5/21/78 (12:01 A.M. Standard Time at the address of the insured stated above)
- **Item 4. Primary Insurance: Insurer(s) and Policy Number(s):** Zurich Insurance Company Policy No. 87-91-601
- **Item 5. Description of Coverage:** Excess Umbrella Liability
- **Item 6. Limits of Liability:** The limit of the Company's liability shall be as stated herein, subject to all the terms of this policy having reference thereto.

## SECTION I IN EXCESS OF SECTION II SECTION III

| Coverage | Company Limits | Underlying Limits | Total Limits |
|----------|----------------|--------------------|--------------|
| A. Bodily Injury | $ Each Person | $ | $ |
|            | $ Each Accident or Occurrence | $ | $ |
|            | $ Aggregate Products | $ | $ |
| B. Property Damage Automobile | $ | Each Accident or Occurrence | $ |
| C. Property Damage Except Automobile | $ | Each Accident or Occurrence | $ |
|            | $ Aggregate Operations | $ | $ |
|            | $ Aggregate Protective | $ | $ |
|            | $ Aggregate Products | $ | $ |
|            | $ Aggregate Contractual | $ | $ |
| D. Combined Single Limit Bodily Injury and/or Property Damage | $ | Each Accident or Occurrence | $ |
|            | $ Aggregate | $ | $ |
| E. Other Excess Umbrella Liability | See Endorsement No. 2 | | |

## Item 7. Premium Computation

| Premium Basis | Estimated Exposure | Rate | Estimated Premium |
|---------------|--------------------|------|--------------------|
| Flat Charge   | N/A                | N/A  | $6,000.           |

## Deposit Premium $6,000 Minimum Premium $6,000 Audit Period

- Named Ins. Endorsement No. 1
- E & O Endorsement No. 4
- Limits of Liability Endorsement No. 2
- Aircraft Products Endorsement No. 5
- E.R.I.S.A. Endorsement No. 3

**Date of Issue:** June 3, 1977
**Countersigned by:** Michael Maloney
**Authorized Representative**

Allendale